If you are applying by the OPM Form 1203-FX, leave this section blank.

8. Other Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

9. Languages

If you are applying by the OPM Form 1203-FX, leave this section blank.

10. Lowest Grade

13

11. Miscellaneous Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

12. Special Knowledge

If you are applying by the OPM Form 1203-FX, leave this section blank.

13. Test Location

If you are applying by the OPM Form 1203-FX, leave this section blank.

14. Veteran Preference Claim

15. Dates of Active Duty - Military Service

16. Availability Date

17. Service Computation Date

18. Other Date Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

19. Job Preference

If you are applying by the OPM Form 1203-FX, leave this section blank.

20. Occupational Specialties

001 Psychologist (HBPC)

21. Geographic Availability

292600047 Excelsior Springs, MO

22. Transition Assistance Plan

23. Job Related Experience

If you are applying by the OPM Form 1203-FX, leave this section blank.

24. Personal Background Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

25. Occupational/Assessment Questions:

Select the appropriate answer to each of the following questions based on your current level of education and/or experience that demonstrates your ability to perform the duties of this position. When answering the questionnaire, remember that your experience and education are subject to verification by investigation. You may be asked to provide specific examples or documentation of experience or education as proof to support your answers, or you may be required to verify a response by a practical demonstration of your claimed ability to perform a task.

In accordance with 38 U.S.C. 7402(d), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. You must be proficient in basic written and spoken English in order to perform the duties of this position.

1. Are you proficient in basic written and spoken English?

A. YesB. No

The following question pertains to your licensure. You must hold a full, current, and unrestricted license to practice psychology at the doctoral level in a State, Territory, Commonwealth of the United States (e.g., Puerto Rico), or the District of Columbia.

2. Do you hold a full, current, and unrestricted license to practice psychology at the doctoral level in a State, Territory, Commonwealth of the United States (e.g., Puerto Rico), or the District of Columbia.

A. YesB. No

The following question pertains to your degree in Clinical or Counseling Psychology. You must have a doctoral degree in psychology (clinical or counseling) accredited by the American Psychological Association (APA) (TRANSCRIPT REQUIRED)

3. Do you have a doctoral degree in psychology (clinical or counseling) from a graduate program in psychology accredited by the American Psychological Association (APA). The specialty area of the degree must be consistent with the assignment for which the applicant is to be employed? [Note: Approved doctoral programs are those from an accredited college or university whose curriculum psychology is approved by the American Psychological Association (APA). Completed study in a specialty area of psychology means completion of a full curriculum in clinical or counseling psychology, not just incidental courses in these areas as part of a program of study in a specialty area unrelated to the position for which being considered. The specialty area of the degree must be clinical or counseling psychology.

A. YesB. No

The following question pertains to your internship. Have you successfully completed a professional psychology internship training program that has been accredited by APA . (MUST PROVIDE School and dates as to when internship was completed).

4. I completed an acceptable internship in psychology, which was accredited by the American Psychological Association (APA). [An acceptable internship consists of an organized training program, in contrast to supervised experience or on-the-job training. The internship was designed to provide the intern with a planned, programmed sequence of training experiences with the primary purpose to assure breadth and quality of training. Such internships may be gained in VA training programs which meet APA internship requirements or in other health service settings whose internships are accredited by the APA. Internships normally consist of 1 year of training under a licensed psychologist in an organization with sufficient staff and varied programs to provide the required breadth and quality of training. The sponsoring organization should provide a written statement or brochure describing the goals and content of the internship with clear expectations for the quantity and quality of the trainee's work. NOTE: Prior to 1956 the APA did not accredit internships, but did accredit doctoral programs. Therefore, a pre-1956 graduate of an APA approved doctoral program in an appropriate psychology specialty, whose internship was acceptable to the degree granting school, meets the internship requirements of this standard.]

The following question pertains to your experience. In additional to meeting the basic requirement, you must have two years of postdoctoral experience appropriate to clinical psychology. The experience must have been gained in a professional program concerned with health, rehabilitation, or vocational restoration and must have demonstrated supervisory abilities.

5. Do you have the above experience described in the paragraph above?

A. YesB. No

This section will be used to determine your ability and willingness to accept certain conditions of employment or meet certain requirements of the position. Respond yes or no to the following statement. FAILURE TO RESPOND TO THIS SECTION WILL RESULT IN AN INELIGIBLE RATING.

6.

I am able and willing to accept a term position/employment not to exceed two (2) years.

A. YesB. No

Please choose A (Yes) or B (No) for each of the following items to identify which of the following descriptions applies to you.

1. Are you are a current permanent VA employee?

A. YesB. No

2. Veterans who served on active duty in the U.S. Armed Forces and were separated under honorable conditions may be eligible for Veterans' preference. For service after October 15, 1976, the Veteran must have received a Campaign Badge, Expeditionary Medal, a service connected disability, or have served during the Gulf War between August 2, 1990 and January 2, 1992 or for more than 180 consecutive days, other than training, any part of which occurred during the period beginning September 11, 2001, and ending on the date prescribed by Presidential proclamation or by law as the last day of Operation Iraqi Freedom. To claim Veterans' preference, Veterans should be ready to provide a copy of their DD-214, Certificate of Release or Discharge from Active Duty, or other proof. Veterans with service connected disability and others claiming "10 point preference" will need to submit Form SF-15, Application for 10-point Veterans' Preference. Please choose the ONE statement below that applies to you.

A. I am eligible for tentative ("5-point") preference.B. I am eligible for "10-point" preference as a 30% or more compensably disabled Veteran.C. I am eligible for "10-point" preference as a compensably disabled Veteran (less than 30%).D. I am eligible for widow or spouse preference.E. I am not eligible for Veterans preference.

3. Your rating is subject to verification based on the resume, narratives and other relevant documents you submit, and through verification of references as appropriate. Deliberate attempts to falsify information are grounds for non-selection and for termination. In addition, falsifying information on your application can result in you being barred from federal employment. Please choose A to certify that your answers are accurate and complete.

A. I certify that my answers are accurate and complete.B. I do not wish to certify. I understand that I will not be considered for this position.